The main objective of this study is to compare the efficacy and safety of aspirin, low molecule heparin and rivaroxaban for preventing catheter-related thrombosis in middle-to-high-risk ambulatory patients with cancer and implantable venous access ports.
Study Type: Interventional, randomized, parallel Assignment and no masking Study Arms \& Intervention: Drug 1: Aspirin, 100mg/day orally; Drug 2: rivaroxaban, 10mg/day orally; Drug 3: low molecule heparin, 4000IU(0.4ml)/day subcutaneous injection; Reference: mechanical prophylaxis. Follow-up Period: 6 months. The trial visits occurred at time before each chemotherapy cycle. The following details should be included at each visit: Khorana score, height and weight, blood routine examination, coagulation function, stool-routine and occult blood test, renal and liver function, ultrasonography of both legs and neck. Primary Outcome: The primary efficacy end point was the occurrence of thrombus in the vein at the puncture site or nearby. The primary was the occurrence of a major bleeding event as defined by the International Society on Thrombosis and Haemostasis (ISTH). Secondary Outcome: The secondary efficacy end point was occurrence of occurrence of other thrombosis or embolism events like deep vein thrombosis or pulmonary embolism. The secondary safety endpoint was the occurrence of any clinically relevant non-major bleeding, minor bleeding and adverse events. Population: patients with cancer and implantable venous access ports Eligibility Criteria: 1. Age 18-75 years; 2. Patients with malignant tumors who received implantable drug delivery devices as intravenous access for systematic chemotherapy; 3. Eastern Cooperative Oncology Group (ECOG) class 0-1; 4. Expected to receive chemotherapy within 1 week of enrollment; 5. Expected survival of more than 6 months; 6. Ambulatory patients or outpatient chemotherapy patients whose intravenous chemotherapy less than 24 hours per hospital stay; 7. Khorana score 1-3 point. Exclusion Criteria: 1. Patients with a history of allergies to low molecular weight heparin, rivaroxaban, aspirin or other non-steroidal anti-inflammatory drugs, especially those with asthma, neurovascular edema or shock; 2. Patients with bleeding risks: thrombocytopenia (platelet count \< 50\*109/L), clinically significant active bleeding, active gastric ulcer disease, severe arterial hypertension, history of previous stroke; 3. moderate to severe liver and kidney dysfunction; 4. pregnant or lactating women; 5. patients who are administered systemically with pyrrole-antimycotic agents (eg ketoconazole, itraconazole, voriconazole and posaconazole) or HIV protease inhibitors (eg ritonavir); 6. Patients taking methotrexate; 7. Patients with systemic use of non-steroidal anti-inflammatory drugs; 8. Patients who have had anticoagulant drugs for any other reason.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
1,640
10mg orally per day
100mg orally per day
0.4ml per day subcutaneous injection
occurrence of catheter-related thrombosis
detect the occurrence of catheter-related thrombosis with ultrasound, venography if necessary
Time frame: from enrollment to the first time of occurrence of catheter-related thrombosis, up to 1 month after the completion of last chemotherapy cycle
occurrence of major-bleeding event
define occurrence of major-bleeding event with ISTH standard
Time frame: from enrollment to the first time of occurrence of major-bleeding event, up to 1 month after the completion of last chemotherapy cycle
occurrence of other thrombosis or embolism events except for catheter-related thrombosis
detect deep vein thrombosis with ultrasound for the lower extremity, , ultrasound for the upper extremity, pulmonary arteriography or venography if necessary
Time frame: from enrollment to the first time of occurrence of other thrombosis or embolism events except for catheter-related thrombosis , up to 1 month after the completion of last chemotherapy cycle
occurrence of clinically relevant non-major-bleeding, minor-bleeding or non-bleeding event
define occurrence of non-major-bleeding or minor-bleeding event with ISTH standard, evaluate the relevant adverse drug reaction with NCI CTCAE 5.0
Time frame: from enrollment to the first time of occurrence of events, up to 1 month after the completion of last chemotherapy cycle
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the People's Hospital of Dongyang City
Dongyang, Zhejiang, China
NOT_YET_RECRUITINGSecond Affiliated Hospital, School of Medicine, Zhejiang University
Hangzhou, Zhejiang, China
RECRUITINGSir Run Run Shaw Hospital, the Affiliated Hospital of Zhejiang University School of Medicine
Hangzhou, Zhejiang, China
NOT_YET_RECRUITINGthe First Affiliated Hospital of Zhejiang University School of Medicine
Hangzhou, Zhejiang, China
NOT_YET_RECRUITINGthe First Affiliated Hospital of Zhejiang University School of Medicine
Hangzhou, Zhejiang, China
NOT_YET_RECRUITINGthe First People's Hospital of Xiaoshan District, Hangzhou
Hangzhou, Zhejiang, China
NOT_YET_RECRUITINGWomen's Hospital of School of Medicine Zhejiang University
Hangzhou, Zhejiang, China
NOT_YET_RECRUITINGZhejiang Provincial Hospital of TCM
Hangzhou, Zhejiang, China
NOT_YET_RECRUITINGZhejiang Provincial Hospital of TCM
Hangzhou, Zhejiang, China
NOT_YET_RECRUITINGZhejiang Provincial People's Hospital
Hangzhou, Zhejiang, China
NOT_YET_RECRUITING...and 18 more locations